{"hospital":{"ccn":"050239","name":"GLENDALE ADVENTIST MEDICAL CENTER","city":"GLENDALE","state":"CA","zip":"91206","phone":"818-409-8202","ownership":"Voluntary non-profit - Private","website_domain":"adventisthealth.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"Adventist Health shall provide charity care (zero patient responsibility) for Self-Pay Patients at or below 200% or less of the Federal Poverty Level.","source_id":"application-9144604435c57343","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Financial Assistance may be applied to uninsured patients, as well as the patient liability for patients with insurance, including charges determined uninsured for the hospital stay, coinsurance, copayment, deductible amounts and other liabilities for medically necessary hospital services.","source_id":"fap-83ffdddfd7847c4f","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":{"value":["Medicaid"],"layer":"documented","quote":"Adventist Health will apply a presumptive Charity Care determination of 100% assistance in the following situations: i. Patient has an active Medicaid plan.","source_id":"fap-83ffdddfd7847c4f","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income","tax_return","pay_stubs"],"layer":"documented","quote":"Provide a copy of patient’s or guarantor’s most recent pay stub (or certify that he or she is currently unemployed); IV. Provide a copy of patient’s or guarantor’s most recent Federal Income Tax Return (including all schedules)","source_id":"application-9144604435c57343","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"in_person","detail":""}],"layer":"documented","quote":"More information about Financial Assistance and paper copies of this Policy and Application are available from any hospital registration area or by phone at (844) 827-5047.","source_id":"fap-83ffdddfd7847c4f","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Application Period – The period during which Adventist Health must accept and process an application for financial assistance under its Financial Assistance Policy submitted by an individual in order to have made reasonable efforts to determine whether the individual is eligible for financial assistance under the policy. The Application Period begins on the date the care is provided and ends on the latter of the 240th day after the date that the first post-discharge billing statement for the care is provided or at least 30 days after Adventist Health provides the individual with a written notice that sets a deadline after which ECAs may be initiated.","source_id":"application-9144604435c57343","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"(844) 827-5047","layer":"documented","quote":"(844) 827-5047","source_id":"fap-83ffdddfd7847c4f","checked_on":"2026-10-11","confidence":1.0,"support_count":0},"hours":null,"languages":null},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-83ffdddfd7847c4f","kind":"hospital_web","url":"https://www.adventisthealth.org/documents/system/financial-assistance-policy-california.pdf","title":"[PDF] Financial Assistance Policy for California-Based Hospitals","fetched_on":"2026-10-11","sha256":"83ffdddfd7847c4f8b5ffc77d2b1f02e4126b215f0a329902a320eea40a4265c","effective_date":null},{"id":"application-9144604435c57343","kind":"hospital_web","url":"https://www.adventisthealth.org/documents/system/financial-assistance-policy-and-application.pdf","title":"[PDF] FINANCIAL ASSISTANCE POLICY - Adventist Health","fetched_on":"2026-10-11","sha256":"9144604435c57343de648406e5367fdfbd2b1258a6a66924733483633c1f94b6","effective_date":null}],"accuracy":null}